Brain Injury Recovery Could Be Delayed in Patients on Anticholinergics

Norwich, United Kingdom—Drugs commonly used in brain injured patients to manage symptoms actually could be delaying recovery, according to a new study.

The study, published recently in the journal Brain Injury, looked at anticholinergics, which are often prescribed to older patients with bladder problems, depression. and insomnia.

Study authors, led by researchers from the University of East Anglia in Norwich, point out that the drugs can cause temporary cognitive impairment, dizziness. and confusion, adding that they wanted to determine the effects on patients with pre-existing brain and spinal injuries. The research is especially important, they add, because medications with anticholinergic properties frequently are used on neurorehabilitation units to manage symptoms ranging from urinary incontinence to pain.

Their study of 52 patients with acquired brain or spinal injury at a neurorehabilitation unit showed that the average length of stay was longer in patients with a higher level anticholinergic drug burden (ACB), while patients with lower ACB were discharged earlier.

“There was a statistically significant correlation of ACB and neuro-disability measures and LOS amongst this patient cohort,” study authors conclude.

“The findings suggest there may be a statistically significant relationship between ACB score and length of stay in a neuro-rehabilitation unit following traumatic brain or spinal cord injury,” lead author Chris Fox, MD, MBBS, MRCPsych, MD Professor of Clinical Psychiatry, said in a University of East Anglia press release. “This pilot study demonstrates the need for larger studies to confirm the results and need for further investigation into what long-term effects these common medications are having on the recovery of these patients.”

He explained that “cognitive impairment due to the medication may adversely affect a patient's ability to engage in the rehabilitation process, potentially increasing their length of stay in hospital.”

Study authors also point out that their research could have financial implications since length of patient stay is used a performance indicator for hospitals, with financial incentives in place for units to discharge patients as soon as safely possible.